Hepatic side-effects of antibiotics

Westphal, Jean‐Frédéric; Vetter, D; Jm, Brogard

doi:10.1093/jac/33.3.387

Cited by 153 publications

(84 citation statements)

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“…Eur Respir J., 1996Respir J., , 9, 2026Respir J., -2030 The most effective antituberculosis (anti-TB) therapy is a combination of isoniazid, rifampin and pyrazinamide for 8 weeks, followed by isoniazid and rifampin for a further 4-7 months (standard therapy) [1]. Despite the development of this powerful regimen, the treatment of tuberculosis continues to be a problem in patients who do not tolerate these drugs [2][3][4]. Surprisingly, although there is a large body of evidence for additive toxicity of the three standard drugs in humans, the incidence of severe adverse effects related to the three major drugs was shown to be low by meta-analysis and in most controlled studies published so far [5][6][7][8][9][10][11].…”

Section: R Ri Is Sk K F Fa Ac Ct To or Rs S F Fo Or R S Si Id De E--ementioning

confidence: 99%

Risk factors for side-effects of isoniazid, rifampin and pyrazinamide in patients hospitalized for pulmonary tuberculosis

Schaberg

Rebhan²,

Lode³

1996

Eur Respir J

331

279

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The aim of this study was to determine the current incidence of side-effects severe enough to cause intolerance of standard antituberculosis therapy with isoniazid, rifampin and pyrazinamide in patients hospitalized as a result of pulmonary tuberculosis. Five hundred and nineteen patients with proven pulmonary tuberculosis, who initially received standard antituberculosis therapy, were retrospectively studied in the department of infectious diseases in a teaching chest hospital. The incidence of severe side-effects related to the therapy, which led to the definitive termination of one of the three standard drugs, was measured and the risk factors for intolerance were analysed. Final termination of either isoniazid, rifampin or pyrazinamide because of severe side-effects was necessary in 121 of the 519 patients (23%). The most severe side-effects leading to final termination of one drug were hepatotoxicity (11%), exanthema (6%), and arthralgia (2%). Pyrazinamide showed more severe side-effects (15%) than isoniazid (7%) and rifampin (1.5%). Significant risk factors for intolerance of the standard therapy following a multivariate analysis were a history of hepatitis (odds ratio (OR) 3.4; 95% confidence interval (95% CI) 1.6-7.6; p = 0.0026) and an age > or = 60 yrs (OR 1.9; 95% CI 1.2-3.2; p = 0.017). Both of these risk factors were also significantly associated with the intolerance of pyrazinamide (history of hepatitis: OR 2.5; 95% CI 1.4-4.3; p = 0.0045; age > or = 60 yrs: OR 2.1, 95% CI 1.3-3.5; p = 0.0029) but not of isoniazid and rifampin. The side-effects of standard antituberculosis therapy are frequent in hospitalized patients aged > or = 60 yrs or with a history of previous hepatitis, and are probably due to pyrazinamide rather than to isoniazid or rifampin.

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Section: R Ri Is Sk K F Fa Ac Ct To or Rs S F Fo Or R S Si Id De E--ementioning

confidence: 99%

Risk factors for side-effects of isoniazid, rifampin and pyrazinamide in patients hospitalized for pulmonary tuberculosis

Schaberg

Rebhan²,

Lode³

1996

Eur Respir J

331

279

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“…2 Extremity injuries are especially susceptible to multiple pathogenic, and sometimes multidrug resistant bacteria, such as methicillin resistant Staphylococcus aureus (MRSA), Pseudomonas aeruginosa (P. aeruginosa), Acinetobacter baumannii, and Escherichia coli. 3,4 Up to 25% of open fractures develop osteomyelitis, bone infection caused by bacteria or fungus, and treatment failure rates are higher when either MRSA or P. aeruginosa are the infecting organisms. [5][6][7] The current standard of care for extremity wounds includes debridement and irrigation of the affected area, as well as fracture stabilization, with serial debridement and irrigation steps to follow.…”

Section: Introductionmentioning

confidence: 99%

Effects of sodium acetate buffer on chitosan sponge properties andin vivodegradation in a rat intramuscular model

et al. 2014

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Chitosan sponges were developed for adjunctive local antibiotic delivery to reduce bacteria in wounds. There is a need to increase sponge degradation for rapid clearance from the wound site during initial wound care. This work examined the effect of using 0.25 M sodium acetate buffers, at pH 4.6 or 5.6, to fabricate sponges with an amorphous chitosan polymer structure. Sponges were evaluated for their crystallinity, thermal, spectroscopic, and morphological properties, in addition to in vitro degradation, and cytocompatibility analysis using normal human dermal fibroblasts. In vivo degradation and biocompatibility were also examined after 4 and 10 days in rat intramuscular tissues. Both buffered chitosan sponge variations exhibited decreases in crystallinity and thermal decomposition temperatures, and increases in surface roughness, which resulted in over 40% increases in degradation over 10 days in vitro compared to the neutral sponges. There were no significant differences between sponges during in vivo degradation over 10 days with respect to histomorphometric analysis of the recovered sponges. These results demonstrated that the acetate buffer did change characteristic chitosan sponge material properties, and increasing the in vivo sponge degradation rate will require balancing material characteristics and processing.

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“…Hepatotoxicity is a very rare phenomenon in children. It has been reported with the use of erythromycin stearate and ethylsuccinate, and the highest incidence appears to be associated with estolate (16). The hepatic toxic effects usually subside upon withdrawal of erythromycin and long-term liver disease has not been reported.…”

Section: 3mentioning

confidence: 99%

Use of erythromycin for the treatment of severe chronic constipation in children

Bellomo-Brandão

Collares

Da-Costa-Pinto

2003

Braz J Med Biol Res

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The efficacy of erythromycin was assessed in the treatment of 14 children aged 4 to 13 years with refractory chronic constipation, and presenting megarectum and fecal impaction. A double-blind, placebocontrolled, crossover study was conducted at the Pediatric Gastroenterology Outpatient Clinic of the University Hospital. The patients were randomized to receive placebo for 4 weeks followed by erythromycin estolate, 20 mg kg -1 day -1 , divided into four oral doses for another 4 weeks, or vice versa. Patient outcome was assessed according to a clinical score from 12 (most severe clinical condition) to 0 (complete recovery). At enrollment in the study and on the occasion of follow-up medical visits at two-week intervals, patient score and laxative requirements were recorded. During the first 30 days, the mean ± SD clinical score for the erythromycin group (N = 6) decreased from 8.2 ± 2.3 to 2.2 ± 1.0 while the score for the placebo group (N = 8) decreased from 7.8 ± 2.1 to 2.9 ± 2.8. During the second crossover phase, the score for patients on erythromycin ranged from 2.9 ± 2.8 to 2.4 ± 2.1 and the score for the patients on placebo worsened from 2.2 ± 1.0 to 4.3 ± 2.3. There was a significant improvement in score when patients were on erythromycin (P < 0.01). Mean laxative requirement was lower when patients ingested erythromycin (P < 0.05). No erythromycin-related side effects occurred. Erythromycin was useful in this group of severely constipated children. A larger trial is needed to fully ascertain the prokinetic efficacy of this drug as an adjunct in the treatment of severe constipation in children. Correspondence

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Hepatic side-effects of antibiotics

Cited by 153 publications

References 0 publications

Risk factors for side-effects of isoniazid, rifampin and pyrazinamide in patients hospitalized for pulmonary tuberculosis

Risk factors for side-effects of isoniazid, rifampin and pyrazinamide in patients hospitalized for pulmonary tuberculosis

Effects of sodium acetate buffer on chitosan sponge properties andin vivodegradation in a rat intramuscular model

Use of erythromycin for the treatment of severe chronic constipation in children

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